Tori Bowie, silver medalist in the 100 meters in Rio (2016) and the fastest woman in the world in 2017, died just three months ago during the delivery of what was to be her first baby. She was found dead on May 2 by welfare officers who came to her Orange County, Florida, home after a few days with no one seeing her. The autopsy cited possible complications suffered by Bowie, including respiratory distress and eclampsia (elevated blood pressure with seizures or coma). The eight-month-old fetus was well developed but failed to survive either.
Before the forensic report was released, some media had speculated on the alleged recklessness of the African-American sprinter and long jumper; in the operation of childbirth “by herself” and in a previous life “erratic and unhealthy”. They were blaming her.
The athlete’s agent, Kimberly Holland, said Bowie, 32, did not trust hospitals: “She wanted to make sure the baby was okay, with her in control.” Holland stressed the falsehood of her insinuations against her client and said she expected an apology once she ruled out that she “had done something to herself.”
The excuses did not come. But some professionals did react to remind the American public of the reality of America’s shocking maternal mortality rates, in fact the highest among advanced nations, as well as the fact that black women here are three times more likely than white women to die of pregnancy-related causes.
We knew that the first superpower is in many ways a country in decline, weighed down by social injustice and large pockets of poverty, by an epidemic of armed violence and serious drug addiction problems; a country in the midst of a crisis of discredit of its institutions and leaders, including a former president and candidate for re-election charged with serious crimes and investigated for an attempted coup.
But could it be said that the richest and most powerful nation on the planet is at the same time an underdeveloped country? If you look at some of the most basic facts about their human development, the answer is a resounding yes.
The US maternal mortality ratio, defined as the number of mothers who died per 100,000 births during pregnancy or in the first year after pregnancy, more than doubled in the 20 years from 1999 to 2019, from 12, 7 (505 deaths) to 32.2 (1,210 deaths), according to the study released Monday by the Journal of the American Association (JAMA), the journal of the American Medical Association.
The negative progression worsened even in 2021, the second year of the pandemic, when maternal mortality in childbirth or the following 42 days reached 32.9 per 100,000 births. Estimates for 2022 point to a return to the less negative but still dire numbers of 2019.
According to the JAMA report, the highest rates by far are among black mothers: 55.4 deaths per 100,000 births in 2019 (26.7 in 1999). And the biggest increases were among American Indians and Alaska Natives, who together went from 14 to 49.2.
“This has to do with health care and access to it in general, but also with structural racism and the policies, procedures and living conditions that can prevent people from living healthy” in certain places and communities, Allison Bryant said. , one of the study authors and medical director of Health Equity at the Mass General Brigham Hospital and Academic Network.
“This is clearly a crisis in the US,” said fellow JAMA report co-author Gregory Roth, director of the cardiovascular health metrics program at the University of Washington.
“We’re going in the wrong direction,” said Elizabeth Cherot, health and medical director for the March of Dimes maternal health NGO. “We are the most dangerous developed country in which to give birth, and the situation is especially worse for Black and Latina women,” Cherot added.
Cardiovascular problems and mental health top the list of direct causes of these deaths, in general. But the bad numbers and the disparities in the US make it necessary to delve into specific structural factors such as poverty, discrimination and worse care for certain communities, in this case those of black women and native communities. Determining the cause of this racial disparity poses “one of the greatest public health challenges” in the United States, says the director of the Harvard Maternal Health task force, Henning Tiemeier.
If the comparison of the superpower with itself is disastrous in this health indicator, its confrontation with the rest of the developed world yields catastrophic results. And it is that the US is the country with the worst maternal mortality rates among all those of its economic level and fourth from the bottom among the 38 in the OECD, only ahead of Colombia, Mexico and Costa Rica.
The situation is not much better in infant mortality, with a national rate of 5.4 deaths in the first year of life for every 1,000 births: the worst rate among the most advantaged countries. In addition, the death rate in children and adolescents aged 0 to 19 grew 20% from 2019 to 2021, the largest increase in 50 years, according to JAMA. The cause: alarming rates of homicide, overdose, traffic accidents and suicide.
It does not seem healthy for such a rich country to neglect the lives of its most precious beings in this way: their mothers and their children. The prognosis is serious.
